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1770107385
ELIZABETH FAYE PRUITT-WISE
DECATUR, GA
NPI
1770107385
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
133V00000X Dietitian, Registered
(Licence: GA 2093)
Enumeration Date
2020-05-31
Last Update Date
2020-05-31
Business Address
ELIZABETH FAYE PRUITT-WISE RD
1670 CLAIRMONT RD
DECATUR, GA 30033-4004
Phone number: 404-321-6111
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Mailing Address
ELIZABETH FAYE PRUITT-WISE RD
1670 CLAIMONT RD
DECATUR, GA 30033
Phone number: 901-592-9880
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